A Diagnostic Dilemma.
CLINICAL PRESENTATION
A 14-year-old male patient reported to the Department of Oral Medicine and Radiology with a complaint of a chronic non-healing ulcer in the lower lip. The patient reported that the lesion appeared 1 month back and is slowly increasing in size since then. He was apparently healthy and well-nourished without any Medical/ Dental history or parafunctional habits. The patient did not recall any physical or chemical trauma to the lip in the past before the appearance of this ulcer.
Clinical examination revealed a large, solitary ulcer on the right side of the lower lip resulting in eversion of the lip. The ulcer was about 3.5cm×2.5cm in greatest dimension. Clinically the non-healing ulcer had presented with a grayish-pink base covered by a white slough and indurated margins (Figure 1) however, sub-mental lymph nodes were palpable. The ulceration was mostly asymptomatic, but the patient had noticed occasional bleeding that would occur either spontaneously or as a consequence of any minor agitation to the area.